OIF vet seeking advice
Diagnosed with OSA by sleep study and prescribed CPAP. Service connected for sinusitis and allergic rhinitis; required sinus surgery.
Initially denied in May 2026. Filed a supplemental in July with a private IMO supporting secondary causation, backed by pages of medical literature. VA sent me to a C&P exam. C&P examiner’s opinion appeared favorable. VA requested a rework addressing aggravation/baseline; the addendum still appeared favorable, but VA denied.
Denial discounts the private IMO as based solely on my reported history, denies aggravation for lack of a baseline, and also states no causal connection.
Planning HLR with an informal conference. How should I challenge the treatment of the favorable opinions and the causation versus aggravation issue?
Anyone dealt with a similar denial?
Edit:
Adding screenshots of the denial for context. My private IMO was six pages, with only a couple paragraphs describing my statements. The rest included medical research/literature, review of my medical records and DD214, and the provider’s rationale linking OSA to my service-connected sinusitis/rhinitis through causation.
The denial characterizes it as based solely on my reported history and gives it little weight. It also denies aggravation because no baseline was established. My understanding is that a baseline is required for aggravation, not causation.
The decision also rejects causation, but I’m questioning whether it adequately evaluated that opinion and explained why it was discounted.